FDA-filed SPL labeling · retrieved through openFDA

Bupivacaine

Bupivacaine is a local anesthetic injection used in adults to numb specific areas of the body for surgery, dental procedures, diagnostic procedures, and obstetrical procedures.

Brand names MarcaineSensorcaineExparelXaracollPosimir +11 more
Drug class ⓘ Amide Local Anesthetic
Rx Forms 2 Routes Perineural · Epidural, Intracaudal, Perineural · Epidural, Infiltration, Intracaudal, Perineural · Infiltration; Perineural +17
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 57 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveDec 12, 2025
Clinical labels in scope ⓘ57
AvailabilityRx
Earliest approval/marketing year ⓘ1972
FDA-listed product records ⓘ292
Boxed warningYes
How we combine label and product data →
⭐ Bupivacaine at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Bupivacaine is a powerful local anesthetic used by healthcare professionals to numb specific areas of the body during surgery, dental procedures, and obstetrical care. It works well when used in the right concentration and technique, but it carries serious risks — including cardiac arrest — if it accidentally enters the bloodstream or is used in settings where it is contraindicated. Always receive it in a monitored medical setting, and make sure your care team knows all the medications you take.
How we write & review this content — our editorial policy →
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾

Bupivacaine Hydrochloride Injection has a serious boxed warning about the risk of cardiac arrest — and possible death — when used for epidural anesthesia in obstetrical (labor and delivery) patients. This risk has been seen most often with the highest concentration (0.75%) of the injection. In reported cases, resuscitation was extremely difficult or impossible, even with proper emergency preparation. Cardiac arrest occurred after seizures caused by the drug accidentally entering the bloodstream. Because of this, the 0.75% concentration of Bupivacaine Hydrochloride Injection must NOT be used for obstetrical epidural anesthesia — it is reserved only for certain surgical procedures requiring deep muscle relaxation and a prolonged effect.

Read the full warning on DailyMed →

📖 Bupivacaine: Patient Information Guide

A plain-language walkthrough of Bupivacaine — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for▾

Bupivacaine is a local anesthetic used across several injection products to numb specific areas of the body in adults. Supported uses across products include:

  • Anesthesia or pain relief for surgical procedures
  • Anesthesia for dental and oral surgery procedures
  • Anesthesia or analgesia for diagnostic and therapeutic procedures
  • Anesthesia for obstetrical procedures (labor and delivery) — with important restrictions by concentration and technique
  • Bupivacaine Hydrochloride and Epinephrine Injection (including Marcaine with Epinephrine and Sensorcaine with Epinephrine) is used for the same range of procedures, with epinephrine added to prolong the duration of effect
  • Not all nerve block types are approved for all products — specific concentrations and presentations are matched to specific procedures, and some uses are restricted due to serious safety risks
⚙️How it works▾

Bupivacaine blocks the generation and conduction of nerve impulses by raising the electrical threshold nerves need to fire and by slowing how fast those signals travel. This stops the nerve from sending pain signals to the brain. The numbing effect follows a predictable order — pain and temperature sensation are lost first, followed by touch, body-position sense, and finally muscle tone. In formulations that include epinephrine, the epinephrine constricts blood vessels at the injection site, slowing how quickly bupivacaine is absorbed into the general circulation and prolonging the duration of the local anesthetic effect.

If bupivacaine reaches toxic levels in the bloodstream — usually from an accidental intravascular injection — it can depress the heart's electrical system, cause dangerous heart rhythm problems, and affect the central nervous system, potentially leading to seizures or cardiac arrest.

💊How it's taken▾

Bupivacaine injection is always administered by a trained healthcare professional in a medical setting — patients do not self-administer it. The concentration used and the method of delivery depend entirely on the type of procedure, the area being numbed, and individual patient factors such as age, weight, and overall health status. Doses are kept as low as possible to achieve the desired effect and are given slowly or in increments to minimize risk. Always follow your care team's specific instructions for your procedure.

🤒Side effects — in detail▾

Common side effects reported with bupivacaine include:

  • Nausea and vomiting
  • Constipation
  • Dizziness
  • Headache
  • Itching (pruritus)
  • Rapid heart rate (tachycardia)
  • Low blood pressure (hypotension)
  • Drowsiness
  • Back pain
  • Swelling in the extremities

More serious reactions — including seizures, cardiac arrest, difficulty breathing, or bluish skin discoloration — require immediate emergency care and should be treated as medical emergencies.

⚠️Warnings & precautions▾
  • Cardiac arrest risk in obstetrical epidural use: The 0.75% concentration of Bupivacaine Hydrochloride Injection must not be used for epidural anesthesia during labor and delivery — it has been linked to cardiac arrest that was difficult or impossible to reverse.
  • Systemic toxicity from accidental intravascular or intrathecal injection: If bupivacaine accidentally enters a blood vessel or the spinal fluid, it can cause seizures, heart rhythm problems, respiratory arrest, and death. Early warning signs include restlessness, metallic taste, ringing in the ears, numbness around the mouth, and dizziness.
  • Chondrolysis (cartilage damage): Continuous infusion of bupivacaine directly into a joint after surgery is not an approved use and has caused irreversible cartilage damage, particularly in the shoulder.
  • Methemoglobinemia: A rare but serious condition where the blood can no longer carry oxygen normally — signs include bluish skin discoloration. Risk is higher in certain patients (see Before Taking).
  • Cardiac arrest with IV regional anesthesia (Bier Block): Bupivacaine injection is contraindicated for use in intravenous regional anesthesia techniques due to reported cardiac arrests and deaths.
  • Liver impairment: Patients with moderate to severe liver disease break down bupivacaine more slowly and are at higher risk for toxic drug levels.
🔀What it interacts with▾

Bupivacaine — particularly formulations containing epinephrine — can interact with several drug classes:

  • Other local anesthetics: Toxic effects are additive; using more than one local anesthetic at a time increases the risk of systemic toxicity.
  • MAO inhibitors and tricyclic antidepressants: Combined with epinephrine-containing formulations, can cause severe, prolonged high blood pressure.
  • Ergot-type oxytocic drugs: Combined with epinephrine-containing formulations, can cause severe persistent high blood pressure or stroke.
  • Nonselective beta-blockers: Combined with epinephrine-containing formulations, can cause severe high blood pressure and slow heart rate (bradycardia).
  • Drugs linked to methemoglobinemia (including nitrates, some antibiotics, antimalarials, anticonvulsants, and acetaminophen): increase the risk of dangerously reduced oxygen-carrying capacity in the blood.
  • Potent inhaled anesthetics: When used with epinephrine-containing formulations, can trigger serious cardiac arrhythmias.
  • Phenothiazines and butyrophenones (certain antipsychotics): May weaken the blood-vessel-constricting effect of epinephrine in combination products.

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it▾
  • Tell your provider about ALL medications you take before receiving bupivacaine — especially antidepressants, blood pressure medications, and any other local anesthetics
  • Anyone with a known allergy to bupivacaine or any other amide-type local anesthetic should not receive this drug
  • Bupivacaine Hydrochloride Injection is not recommended for children under 12 years old — continuous infusions in children have caused dangerously high drug levels and seizures
  • Adults 65 and older — especially those with high blood pressure — are at increased risk for low blood pressure (hypotension) during use; lower doses may be needed
  • People with moderate to severe liver disease cannot metabolize bupivacaine normally and are at greater risk for toxic drug levels; extra monitoring is required
  • People with kidney disease are at greater risk for side effects; dose selection requires care
  • Bupivacaine is contraindicated for obstetrical paracervical block — this technique has caused fetal heart rate slowing and death
  • Pregnant women: local anesthetics cross the placenta and can affect the baby; risks and benefits should be discussed with your provider
  • Breastfeeding: bupivacaine passes into breast milk; use only if clearly necessary
  • Patients with glucose-6-phosphate dehydrogenase deficiency, heart or lung compromise, or those taking drugs associated with methemoglobinemia are at higher risk for that serious blood oxygen condition
🚑If you take too much▾

Too much bupivacaine in the bloodstream — most often from accidental injection into a blood vessel — can cause nervous system symptoms such as dizziness, confusion, ringing in the ears, numbness around the mouth, and seizures, as well as heart effects including dangerous rhythm changes, very low blood pressure, and cardiac arrest. Emergency treatment focuses on keeping the airway open, supporting breathing with oxygen, and managing the heart and circulation; seizures may require IV medications. If cardiac arrest occurs, standard CPR and resuscitation measures are used immediately.

📡Pharmacodynamics — effects in the body▾

At normal therapeutic doses, bupivacaine's effects stay local — changes to heart rhythm, blood pressure, or circulation are minimal. However, if toxic amounts reach the bloodstream, bupivacaine depresses the heart's electrical conduction and muscle function, which can lead to heart block, dangerous arrhythmias, low blood pressure, and cardiac arrest. It can also affect the brain and nervous system, first causing stimulation (restlessness, tremors, seizures) and then depression (coma, respiratory arrest). These cardiovascular effects are much more likely after accidental intravascular injection. For dental procedures, onset of numbing typically begins within 2–10 minutes and can last up to 7 hours; adding epinephrine prolongs this effect further.

🔬Pharmacokinetics — how your body processes it▾

How quickly bupivacaine is absorbed into the general circulation depends on where and how it is injected, the total dose given, and how much blood flow is present at the injection site. It is metabolized (broken down) primarily by the liver, which is why liver disease increases the risk of toxic drug levels building up. The drug is substantially cleared by the kidneys, making kidney disease a factor in dosing decisions. The duration of bupivacaine's numbing effect at the local site is longer than most other short-acting local anesthetics, and a period of pain relief often persists even after sensation has returned.

📦How to store it▾

Store bupivacaine liposome injectable suspension vials refrigerated between 2° to 8°C (36° to 46°F). refrigerate vials. Do not freeze or expose bupivacaine liposome injectable suspension to high temperatures (greater than 40°C or 104°F) for an extended period.

📄 Written from Bupivacaine’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Bupivacaine — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is bupivacaine and why is my doctor using it? ▾
Bupivacaine is a local anesthetic — it numbs a specific area of your body so you don't feel pain during a procedure. Your doctor or anesthesiologist injects it near the nerves that supply the area they're working on, and it blocks those nerves from sending pain signals to your brain. It's commonly used for surgeries, dental procedures, and during labor and delivery.
What side effects should I expect after getting bupivacaine? ▾
The most common ones are nausea, vomiting, constipation, dizziness, and headache. You might also notice your heart beating a little faster or your blood pressure dropping temporarily. Most of these settle on their own as the medication wears off. If you feel restless, notice a metallic taste in your mouth, hear ringing in your ears, or feel numbness around your lips, tell your care team right away — those can be early signs that the drug level in your blood is getting too high.
Are there any warning signs I should take seriously and call for help immediately? ▾
Yes — if you experience a seizure, feel your heart racing or fluttering severely, have trouble breathing, lose consciousness, or notice your skin turning bluish, those are emergencies and you need immediate medical help. These can signal that bupivacaine has reached toxic levels in the bloodstream, which is a rare but serious complication. Your care team will be monitoring you closely to catch any early warning signs.
Can I receive bupivacaine if I'm pregnant or breastfeeding? ▾
It depends on the type of procedure and the injection technique. Bupivacaine is used in obstetrical care — including epidurals for labor — but there are strict restrictions. One specific technique called paracervical block is completely off-limits during pregnancy because it has caused serious harm to babies. If you're breastfeeding, bupivacaine does pass into breast milk, so your doctor will only use it if it's clearly necessary. Always tell your care team if you are pregnant or nursing before any procedure.
Are there medications I should tell my doctor about before I receive bupivacaine? ▾
Definitely — this is important. Some antidepressants (especially MAO inhibitors and tricyclic antidepressants), certain blood pressure medications (nonselective beta-blockers), and ergot-type drugs used to control bleeding after delivery can all cause dangerous interactions, particularly if you're receiving a formulation that also contains epinephrine. Other local anesthetics, certain antibiotics, and antimalarial drugs can also increase specific risks. Give your provider a full medication list before any procedure.
Is bupivacaine safe for children or older adults? ▾
For children under 12, bupivacaine injection is generally not recommended — it can build up to dangerous levels in young children more easily, and continuous infusions have caused seizures in this age group. For older adults (65 and over), especially those with high blood pressure, there's a higher risk of blood pressure dropping during the procedure, so doses are often adjusted and monitoring is closer. If you have liver or kidney disease at any age, your care team will take extra precautions because your body processes the drug more slowly.
Is Bupivacaine available over the counter? ▾
Bupivacaine is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Bupivacaine first available? ▾
Bupivacaine has been available in the United States since at least 1972, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Bupivacaine? ▾
Bupivacaine is supplied by 59 manufacturers listed in the FDA NDC Directory, including Hospira, Inc., Hikma Pharmaceuticals USA Inc., Fresenius Kabi USA, LLC.

💬 Answers drafted from Bupivacaine’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

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💊 How Bupivacaine comes

Bupivacaine is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Injection

By injection · Infiltration · Into a vein · Into the epidural space · Intracaudal · Intraspinal · Parenteral · Perineural · Retrobulbar · Subarachnoid
Brands Bupivacaine Hci Burapren 0.5% Burapren 0.75% Durapren 0.5% Durapren 0.75% Exparel Marcaine Marcaine Spinal Marvona-25 SUIK Marvona SUIK Posimir Sensorcaine Sensorcaine MPF Xaracoll
How this form is used
What it may be used for
  • Used in adults for local or regional anesthesia and pain relief for surgical, dental and oral surgery, diagnostic, therapeutic, and obstetrical procedures
  • Bupivacaine Hydrochloride and Epinephrine Injection is used for the same range of procedures; the epinephrine ingredient helps prolong the numbing effect by slowing absorption into the bloodstream
  • Not every route or concentration is approved for every block type — specific concentrations are matched to specific procedures
  • The 0.75% concentration is not recommended for obstetrical epidural use and is reserved for surgical procedures requiring deep muscle relaxation
Important instructions
  • Administered only by a trained healthcare professional; not for self-administration
  • Not for intrathecal (directly into spinal fluid) use
  • Solutions from multiple-dose vials that contain antimicrobial preservatives must not be used for epidural or caudal anesthesia
  • Unused portions of single-dose vials without preservatives should be discarded after initial use
Available strengths 13 strengths
2.5 mg/mL 5 mg/mL 7.5 mg/mL 13.3 mg/mL 25 mg/10 mL 40 mg/mL
Show 7 more strengths Show fewer strengths
50 mg/10 mL 75 mg/30 mL 100 mg 150 mg/30 mL 225 mg/30 mL 250 mg/50 mL 660 mg/5 mL
264 FDA-listed product records ⓘ

Oral solution

By mouth · Infiltration
Brands Posimir
How this form is used
What it may be used for
  • Posimir is a bupivacaine product administered by infiltration at or around a surgical site
Important instructions
  • Posimir is administered by a healthcare professional by infiltration into the surgical area
  • Follow the prescribing information specific to Posimir for administration guidance
Available strengths 2 strengths
7.5 mg/mL 660 mg/5 mL
2 FDA-listed product records ⓘ

📊 Bupivacaine across the U.S. market

How Bupivacaine appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

2
Dose forms ⓘ
59
Manufacturers
19
Brand names
292
FDA-listed product records ⓘ
1972
First marketed ⓘ

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (26) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Hospira, Inc.16%
Hikma Pharmaceuticals USA Inc.8%
Fresenius Kabi USA, LLC7%
Henry Schein, Inc.6%
Eugia US LLC6%
NorthStar RxLLC4%
Other makers53%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Bupivacaine is used

A general measure of how commonly Bupivacaine is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Bupivacaine is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

166,102
Medicaid prescriptions filled (Q1–Q4 2025)
$18.7M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Bupivacaine prescribed? Of the 1,596 medications we measure, Bupivacaine ranks #420 by Medicaid prescriptions — more than 74% of them.

Where Bupivacaine ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5
Total prescriptions — #420 of 1,596
#415 Irbesartan 172,404 Rx #416 Mesalamine 171,248 Rx #417 Serdexmethylphenidate... 170,163 Rx #418 Linagliptin 168,433 Rx #419 Diazepam Nasal Spray 167,844 Rx #420 Bupivacaine 166,102 Rx #421 Cefadroxil 165,523 Rx #422 Phenobarbital 164,240 Rx #423 Doxazosin 163,836 Rx #424 Fludrocortisone Acetat... 163,820 Rx #425 Ritonavir 162,610 Rx

Utilization by Bupivacaine product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 10 mL / 2.5 mg/mL injection is the most-dispensed Bupivacaine product — about 18% of these Medicaid prescriptions.

10 ML bupivacaine hydrochloride 2.5 MG/ML Injection Most dispensed

30,068 Medicaid prescriptions (Q1–Q4 2025) 18% of Bupivacaine prescriptions shown $2.2M gross reimbursement (before rebates) ≈ $74 per prescription (gross)

Summed across the 6 of 37 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1725078

30 ML bupivacaine hydrochloride 2.5 MG/ML Injection

29,745 Medicaid prescriptions (Q1–Q4 2025) 18% of Bupivacaine prescriptions shown $3.8M gross reimbursement (before rebates) ≈ $127 per prescription (gross)

Summed across the 9 of 28 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1725082

30 ML bupivacaine hydrochloride 5 MG/ML Injection

24,729 Medicaid prescriptions (Q1–Q4 2025) 15% of Bupivacaine prescriptions shown $2.7M gross reimbursement (before rebates) ≈ $110 per prescription (gross)

Summed across the 8 of 28 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724884

10 ML bupivacaine hydrochloride 5 MG/ML Injection

21,842 Medicaid prescriptions (Q1–Q4 2025) 13% of Bupivacaine prescriptions shown $1.3M gross reimbursement (before rebates) ≈ $62 per prescription (gross)

Summed across the 7 of 40 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724880

bupivacaine hydrochloride 5 MG/ML Injectable Solution

14,747 Medicaid prescriptions (Q1–Q4 2025) 9% of Bupivacaine prescriptions shown $363,354 gross reimbursement (before rebates) ≈ $25 per prescription (gross)

Summed across the 10 of 45 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1012404

bupivacaine hydrochloride 2.5 MG/ML Injectable Solution

11,231 Medicaid prescriptions (Q1–Q4 2025) 7% of Bupivacaine prescriptions shown $403,950 gross reimbursement (before rebates) ≈ $36 per prescription (gross)

Summed across the 7 of 34 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1012396

20 ML bupivacaine liposome 13.3 MG/ML Injection

8,835 Medicaid prescriptions (Q1–Q4 2025) 5% of Bupivacaine prescriptions shown $4.1M gross reimbursement (before rebates) ≈ $460 per prescription (gross)

Summed across the 2 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1191508

10 ML bupivacaine liposome 13.3 MG/ML Injection

4,612 Medicaid prescriptions (Q1–Q4 2025) 3% of Bupivacaine prescriptions shown $1.9M gross reimbursement (before rebates) ≈ $417 per prescription (gross)

Summed across the 2 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1745061

10 ML bupivacaine hydrochloride 7.5 MG/ML Injection

2,275 Medicaid prescriptions (Q1–Q4 2025) 1% of Bupivacaine prescriptions shown $64,133 gross reimbursement (before rebates) ≈ $28 per prescription (gross)

Summed across the 6 of 19 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724787

2 ML bupivacaine hydrochloride 7.5 MG/ML Injection

941 Medicaid prescriptions (Q1–Q4 2025) <1% of Bupivacaine prescriptions shown $224,637 gross reimbursement (before rebates) ≈ $239 per prescription (gross)

Summed across the 2 of 16 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724784

30 ML bupivacaine hydrochloride 7.5 MG/ML Injection

685 Medicaid prescriptions (Q1–Q4 2025) <1% of Bupivacaine prescriptions shown $84,259 gross reimbursement (before rebates) ≈ $123 per prescription (gross)

Summed across the 3 of 23 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1724786

Other Bupivacaine products — combination packs and listings not yet matched to a specific clinical product (kept visible so every prescription is accounted for)

16,392 Medicaid prescriptions (Q1–Q4 2025) 10% of Bupivacaine prescriptions shown $1.5M gross reimbursement (before rebates) ≈ $93 per prescription (gross)

Summed across the 19 of 99 listed NDC products with Medicaid activity.

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Bupivacaine, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 81 of 377 listed Bupivacaine NDCs with Medicaid activity.

🔍 Compare Bupivacaine products

A representative set of FDA-listed product records for Bupivacaine — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 200 of 292 products — FDA National Drug Code Directory. See every product, package size and price: browse all 292 Bupivacaine NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Bupivacaine RxCUI 1815 3 dose forms · 17 strengths
  1. Dose form (SCDF) Drug Implant RxCUI 2395790 No current FDA listing
    Clinical drug / strength (SCD) hydrochloride 100 MG RxCUI 2395791
  2. Dose form (SCDF) Injectable Solution RxCUI 371160 In current FDA listings
    Clinical drug / strength (SCD) hydrochloride 1.05 MG/ML RxCUI 1012431 hydrochloride 2.5 MG/ML RxCUI 1012396 hydrochloride 5 MG/ML RxCUI 1012404
  3. Dose form (SCDF) Injection RxCUI 1724783 In current FDA listings
    Clinical drug / strength (SCD) 2 ML bupivacaine hydrochloride 7.5 MG/ML RxCUI 1724784 5 ML bupivacaine 132 MG/ML RxCUI 2563412 5 ML bupivacaine hydrochloride 2.5 MG/ML RxCUI 2178759 5 ML bupivacaine hydrochloride 5 MG/ML RxCUI 2178760 10 ML bupivacaine hydrochloride 2.5 MG/ML RxCUI 1725078 10 ML bupivacaine hydrochloride 5 MG/ML RxCUI 1724880 10 ML bupivacaine hydrochloride 7.5 MG/ML RxCUI 1724787 10 ML bupivacaine liposome 13.3 MG/ML RxCUI 1745061 20 ML bupivacaine hydrochloride 2.5 MG/ML RxCUI 1725696 20 ML bupivacaine liposome 13.3 MG/ML RxCUI 1191508 30 ML bupivacaine hydrochloride 2.5 MG/ML RxCUI 1725082 30 ML bupivacaine hydrochloride 5 MG/ML RxCUI 1724884 30 ML bupivacaine hydrochloride 7.5 MG/ML RxCUI 1724786

Look up RxCUI 1815 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Marcaine Sensorcaine Exparel Xaracoll Posimir Nocita Sensorcaine MPF Marcaine Spinal Marvona SUIK Bupivacaine Hci Marvona-25 SUIK Durapren 0.75% Durapren 0.5% Burapren 0.75% Burapren 0.5% Bupivacaine Spinal

🏭 Manufacturers & labelers

Hospira, Inc. 45 Hikma Pharmaceuticals USA Inc. 22 Fresenius Kabi USA, LLC 18 Henry Schein, Inc. 16 Eugia US LLC 16 NorthStar RxLLC 12 General Injectables & Vaccines, Inc 11 HF Acquisition Co LLC, DBA HealthFirst 10 AuroMedics Pharma LLC 8 Xellia Pharmaceuticals USA LLC 8 Steriscience Specialties Private Limited 8 Meitheal Pharmaceuticals Inc 8 Onesource Specialty Pharma Limited 8 Asclemed USA, Inc. 7 Medical Purchasing Solutions, LLC 6 Pacira Pharmaceuticals, Inc. 6 Henry Schein, Inc 6 Somerset Therapeutics, LLC 4 IT3 Medical LLC 4 Fosun Pharma USA Inc. 4 Areva Pharmaceuticals 4 Jiangsu Hengrui Pharmaceuticals Co., Ltd. 3 Huons Co., Ltd. 3 Anthea Pharma Private Limited 3

…and 16 more on the FDA NDC directory.

RxNorm drug class

Bupivacaine belongs to the Amide Local Anesthetic class.

Pharmacologic class Amide Local Anesthetic
Drug family (ATC) Amides

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Dec 12, 2025
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Bupivacaine.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Bupivacaine after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
57
NDC products indexed
292
Distinct labelers/manufacturers represented
59
Linked representative label ⓘ
Pacira Pharmaceuticals, Inc.
Linked label effective
Dec 12, 2025
Composite sections available
23
Linked SPL Set ID
bb5a9e59-0f51-11df-8a39-0800200c9a66
Linked SPL Document ID
7dd52279-ea2e-4f8c-8e29-8172bc3ed882
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 57 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Pacira Pharmaceuticals, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.